If a patient can use the GI tract but is at risk for aspiration, what type of feeding tube should be used?

In cases where a patient can use the gastrointestinal (GI) tract but is at risk for aspiration, the best choice for a feeding tube is a jejunal tube. The jejunal tube is inserted into the jejunum, which is more distal in the small intestine than the stomach. This positioning helps to minimize the risk of aspiration because it bypasses the stomach, where the contents can potentially be refluxed back up into the esophagus and subsequently aspirated into the lungs.

Patients who have difficulties with swallowing or who have impaired airway reflexes are often at higher risk for aspiration, which can lead to serious complications such as aspiration pneumonia. By utilizing a jejunal tube for feeding, the risk of aspirating gastric contents is significantly reduced, as the feeding is delivered directly into the small intestine.

Other types of feeding tubes, such as gastric tubes and nasogastric tubes, allow for access to the stomach, which increases the potential for aspiration. A duodenal tube is also an option but is less commonly used compared to a jejunal tube in cases specifically aimed at reducing aspiration risk. Therefore, the jejunal tube is the most appropriate choice for patients who are at risk of aspiration while still being able to utilize their GI tract for nutrient absorption.